| NPI | 1174994636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME145509) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 97966) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 97966) | |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2026-05-22 |